This thesis examines the relationship between approach-avoidance tendencies, psychopathology, and cognition. It focuses on interventions targeting approach bias toward alcohol cues in individuals with alcohol-related cognitive impairments and Korsakoff’s syndrome, as well as a compensatory cognitive training in a neuropsychiatric population.
Results of a systematic review indicated that an approach tendency toward substance-related cues may increase the risk of future substance use. Evidence most consistently supports the effectiveness of approach bias modification in alcohol use disorder. Clinical studies within this thesis demonstrated that this intervention is also feasible for individuals with alcohol-related cognitive impairment or Korsakoff’s syndrome. This is clinically relevant because cognitive impairment negatively affects treatment outcome and prognosis. The findings are also important from a theoretical perspective, given that bias modification is thought to depend on implicit learning processes which remain relatively intact in these populations. Therefore the relationship between declarative memory and changes in cognitive bias is studied: Individuals with impaired declarative memory appear to rely mainly on procedural learning and benefit from additional training sessions. In contrast, participants with relatively preserved memory functioning seem less dependent on the number of training sessions. These findings suggest that explicit learning processes may play a role in approach bias modification.
Finally, the compensatory cognitive training “Master Mind” proved feasible and acceptable for people with various mental health conditions. Preliminary findings suggest improvements in proactive coping and life satisfaction, regardless of cognitive ability. A transdiagnostic application of compensatory cognitive training may increase accessibility and scalability in mental health care.